Editorial notes

exacerbation of the family difficulties rather than being of any positive benefit. But as the two agencies worked in co-operation and the vocational planning went on in close correlation with the family situation, the vocational counseling process combined with the casework counseling process not only helped to clarify the boy's vocational plan, but also served to reinforce the over-all family unity and make it possible for the parents and Sam to live together more harmoniously. Vocational guidance and social work 429

have a great deal in common and have much respectively to contribute to the young person's movement toward well-balanced maturity. Their joint contribution can best be realized through co-operation growing out of mutual respect and acceptance of the differentiated functions of the two fields. Both professions have a good deal to do internally in the clarification of their special skills, but these problems need not prevent the kind of co-operation which can produce more effective service for their clients.

EDITORIAL NOTES
Miss Hoey's article, presented at the Fifth International Conference of Social Work in Paris last July, reflects the general theme of the Conference, "Social Work in 195o-Its Boundaries-Its Content." Her paper encompasses the many and varied areas in which social work operates, and views with equal appreciation its role in the offering of individual services and in the development of social policies on a national and international level. In her analysis of the knowledges and skills basic to social work, her clarity as to its essential aims and purposes, and her conviction as to the contribution it can make in the world of today, Miss Hoey presents material that has significance for social workers in whatever field they may be practicing. The need for social work to "define areas of competence and to make more specific the science of human relations upon which its practice is based" is a concern of the total field and takes on new import in the light of present world tensions.
We are pleased to be able to publish the two articles by Dr. Himes and Miss Anderson on concepts of blindness and the relation of the social worker to these concepts. Since SOCIAL CASEWORK has not carried any articles on the subject of blindness since February, 1946, we are fortunate in having these papers made available.
The American Foundation for the Blind, on whose program both of these papers were presented at the 1950 National Conference of Social Work, is a national private agency located in New York City. It has long been recognized that the greatest bar to normal living for the blind is the attitude of the seeing public toward blindness. The many activities of the Foundation, bringing it into contact with agencies and workers for both the blind and sighted, and with all phases of work with the blind, have borne this out. In spite of the dissemination of a great deal of information, it is still true that the majority of seeing persons are unable to accept blind people as individuals capable of leading normal lives. Even caseworkers, trained to accept individual differences and to be .aware of their own reactions in dealing with clients, fall into the error of regarding the blind as a special class. Recognition of how deeply rooted this attitude is led to the decision to explore this in a series of programs arranged in connection with the National Conference of Social Work. The first of these, presented in 1949, dealt with the psychiatric aspects of this attitude toward blindness, and the 1950 program was devoted to its sociological aspects.
Dr. Himes' and Miss Anderson's papers bring out both the possibilities and limitations in what may be achieved through casework in the cultural setting in which the blind of our society must live. They bring to our attention the need for research and for a planned program of social action Social Casework so that casework treatment may be supplemented "by a broad approach designed to alter the concepts of blindness in om culture." This book is an outgrowth of the author's earlier publication, The Medical Value of Psychoanalysis. The purposes of the present publication are, as the author states, to summarize the basic concepts on which the psychosomatic approach in medicine is founded and to present the results of systematic investigation in this field.
The first part of the volume, entitled "General Principles," is concerned with a historical review of the various ideas that contributed to presentday psychosomatic thinking. This introduction forms a background against which the author then presents his methodological considerations and fundamental principles of the psychosomatic approach; these are discussed under the headings of psychogenesis, physiological functions affected by psychological influences, specificity of emotional factors in somatic disturbances, personality type and disease, and the relation of nervous and hormonal mechanisms.
In the second part, which comprises the bulk of the volume, the author considers the emotional factors in different diseases. In succession he takes up gastrointestinal, respiratory, cardiovascular, skin, metabolic and endocrine, as well as joint and muscle, diseases. The disturbances of the sexual apparatus are considered in a separate article written by Therese Benedek. The volume concludes with a chapter on therapy and a selected bibliography.
The book is essentially a textbook; complex problems have been simplified, integration of knowledge deriving from various health disciplines is attempted, encyclopedic treatment has been renounced for the sake of clarity, and the style makes for easy reading. Especially for those readers whose training and experience were acquired in the fields of social work, psychology, biochemistry, or medicine, this book should prove valuable, as the author presupposes little psychiatric knowledge on the part of the reader. It goes without saying that the author pays particular attention to the theoretical formulations and the psychosomatic studies of the Institute for Psychoanalysis in Chicago.
This fact carries some interesting implications: Because psychoanalysts, especially Dr. Alexander and his co-workers, were among the first to recognize the need for a more holistic approach to patients than was heretofore customary, psychoanalytic methods and theories were used to understand facts that concurrently were observed in the mental and somatic spheres. Inasmuch, however, as the psychoanalytic system was devised to explain data obtained in the psychological sphere, it did not lend itself readily to the treatment of information pertaining to the somatic sphere. The same, in reverse, was true of the physiological systems when they were applied to the explanation of psychological facts. New concepts therefore had to be created that would enable the physician to switch over from one system to another. In the end, then, at least two sets of facts, two scientific systems, and one set of hypotheses linking together the two systems, were necessary to cope with the subject matter of psychosomatic medicine. In so doing, the mind-body dichotomy, which psychosomatic medicine purports to eliminate implicitly, still is carried along to the extent of expressing the dichotomy even in the label "psychosomatic." This state of affairs in matters psychosomatic is clearly reflected in Dr. Alexander's book, which illustrates the point that, if two different scientific systems are combined, the sum or product of the two systems does not necessarily create a new system encompassing the characteristics of both. Today there is a need for a new system to explain the various aspects of human behavior in terms of one set of variables. So far, this step has not been undertaken, although some straws in the wind indicate that there is something in the making. Be that as it may, the present volume seems to mark the end of the dichotomous era in medicine; it crowns the pioneering efforts of two decades' duration to introduce again the human being into medicine.